Influence of adjunctive balloon angioplasty on coronary blood flow after rotational atherectomy

Rotational atherectomy is being performed with increasing frequency in a distinct subset of patients whose lesion characteristics are unfavorable for conventional balloon angioplasty. Although satisfactory luminal enlargement can be accomplished with the use of rotational atherectomy alone in some patients, adjunctive balloon angioplasty is necessary in most patients, to obtain a minimal residual angiographic result. To demonstrate responses associated with rotational atherectomy results, serial coronary blood flow measurements were obtained in a patient undergoing rotational atherectomy for unstable angina. Adjunctive balloon angioplasty resulted in normalization of post‐stenotic coronary flow reserve. Recanalization by rotablator alone may not normalize coronary flow despite a satisfactory angiographic result. © 1995 Wiley‐Liss, Inc.